Sickle-cell anaemia is a genetic disorder, but recent studies have found that eating traditional foods rich in thiocynate such as African yams, lima beans, steamed carrots, cabbage and other such whole non-chemically processed food can reduce its painful symptoms. CHKWUMA MUANYA reports.

Ifeanyi Adeleke was diagnosed with sickle cell anaemia (Hb SS) in 1998. According to Western medicine, it is an incurable, life-threatening disease, discovered in 1910 in the United Sates.

Studies have shown that Sickle cell disease is an inherited blood disorder. Normally, red blood cells are disc-shaped and flexible. In sickle cell disease, however, haemoglobin (the chemical within red blood cells that carries oxygen around the body) is abnormal. This defect causes red blood cells to collapse into a crescent, or sickle, shape.

These abnormal blood cells are destroyed at an unusually high rate, causing a shortage of red blood cells (anaemia). In addition, they can suddenly clump together and clog up small blood vessels throughout the body. This clumping causes what is called a sickle cell crisis.

When blood vessels are blocked by sickle-shaped red blood cells, parts of the body are deprived of oxygen. This can cause severe pain and damage to the organs and tissues that are deprived.

Reported common triggers of sickle cell crisis include smoking, strain, exposure to high altitudes, fever, infection, dehydration, and the drop in oxygen or changes in air pressure that can occur during airplane travel.

Diagnosis of sickle cell disease (Hb SS) and sickle cell trait (Hb AS-a condition in which a person has one of the two genes necessary to develop sickle cell disease), according to a consultant gynaecologist at Optimal Specialist Hospital Surulere, Lagos, Dr Ugochukwu Chuwunenye, can be done through blood testing, using a technique called haemoglobin electrophoresis. Treatment, he says, involves managing the anaemia, chronic pain, and organ damage caused by sickle cell disease. "In addition, the drug hydroxyurea can reduce occurrences of sickle cell crisis. Of course, it is also important to minimise exposure to conditions or situations that can trigger sickle cell crisis."

Indeed, Ifeanyi's father and mother both have traces of sickle cell anaemia (Hb AS). Medical science claims that genetically there is a one in four chance that any child born to this couple would have anaemia.

The major treatments for this condition under the Western medical system are the administration of morphine or other pain killers, liquids for dehydration, blood transfusion, hydroxy urea, chemotherapy, antibiotics, flu shot, hepatitis B shot and, in extreme cases, bone marrow transplants.

Considering the toxicity and side effects of these treatments, most Nigerians are seeking other, less toxic methods of treatment and control, especially for children and infants!

Contrary to the view in Western science that sickle cell anaemia is mostly a black people's problem, Dr. Oji Agbai, a Nigerian researcher living in the United States, has shown that sickle cell anaemia is found in all races. On a per capita basis, it is most prevalent in Greece.

Once it was confirmed that Ifeanyi did have sickle cell anaemia, the parents consulted homeopath Osmond Ifeanyi and herbalist Godwin Ihesie. They explained to both practitioners what Ifeanyi had, and they began to treat all underlying aspects of this condition that would result in complications, like an enlarged spleen, jaundice, a lack of appetite and low haemoglobin.

They acquired the herb prickly ash bark, which has been successfully used by the Nigerian health services. This herb is commonly known as Fagara in Nigeria. Prickly ash bark has been shown to reduce the length and the frequency of the pain crises by up to 75 per cent. Ifeanyi drinks this herb as tea.

Agbai's thesis is that certain people are genetically disposed to thiocynate deficiency (a deficiency of vitamin B12-- a necessary component to health blood cells). This deficiency causes blood cells to "sickle," and is the root cause of sickle cell anaemia and its resulting complications. But once this thiocynate was present in sufficient quantity in the blood system, there is an immediate unsickling of the blood cells and a consequent abatement of the complications that may arise.

Agbai had worked with the Nigerian health services as a nurse. In that capacity he had observed the relative mildness of the symptoms of sickle cell anaemia as compared with what he was later to see in the United States. His findings are that diets rich in nutritional thiocynate protected against sickle cell anaemia. This explained its mildness and rarity in many parts of Africa, Jamaica and elsewhere in the world where staple foods such as yams, cassava and lima pea are naturally rich in thiocynate.

Agbai says the frequency and severity of sickle cell anaemia in America are expressions of the nutritional poverty of American staple food, especially regarding thiocynate. Once people with sickle cell anaemia adopted a diet rich in thiocynate-- African yams, lima beans, steamed carrots, cabbage and other such whole non-chemically processed food-- they experience a normally healthy life, free from the pains of that anaemia's complication and at the same time being spared the debilitating treatment used in the Western medical system to "combat" this condition.

Carrots are rich in thiocynate so Ifeanyi drinks carrot and beet juice daily. He enjoys curried lentils and rice, so he eats that for dinner about three times a week. "I am gradually trying gradually trying to introduce Ifeanyi to as many foods as he will try that are rich in thiocynate. Some he loves, some he would not eat. I restrict the amount of the non-traditional foods, especially junk foods, soft drinks and whatever has no nutritional value", says Ifeanyi's mother.

She continued: "Usually when I take Ifeanyi out I bring food with us because I find that he either would not eat or he wants foods that he should not have. I bake treats from time to time, but again I focus on thiocynate-rich ingredients. He will eat a banana cake or bead but not a buckwheat cake. He will eat combined buckwheat and oatmeal porridge but not buckwheat porridge alone.

"Because Ifeanyi does not eat the daily required level of thiocynate between 500-1000 mg, I have purchased a supplement from Dr. Agbai, which he takes daily. I explained to him why he has to eat the way he does and drink the herb teas. Although he is only two years old, he understands. As he grows older I will teach him how to cook his meals and I will give him the books with all the necessary information about his health for him to read.

"Since Ifeanyi started his treatment, he has increased noticeably in weight and height, contrary to the prognosis of Western medical science that his growth and weight rate will be stunted because of his blood type. Though we realise there may not be a way to change human blood genotypes, we are very confident that Ifeanyi will have a bountiful and healthy life.

"The times he has gone for routine check ups, the hospital staff including the doctors, have been impressed with Ifeanyi's growth rate and energy level, which is above the average two-year-old's. Many of the hospital staff who have observed children with sickle cell anaemia brought to the hospital over the years have confessed to me privately that Ifeanyi is unlike other "sickle cell patients" they have known. Indeed, many such children are admitted for health complications at least once every two to three months. Ifeanyi has never been admitted in the hospital.

"Ifeanyi now has a healthy appetite, the jaundice which used to plague him in the past is effectively controlled with Dr. Agbai's thiocynate solution. He almost never gets sick, save for the occasional cold in winter time. He has had only two very mild pain crises in the past year, and those were gone as soon as they came. Since we put him on Dr. Agbai's thiocynate solution and gave him the prickly ash bark tree daily, he has not had any crisis.

"Everyone who has dealt with sickle cell anaemia clinically is truly impressed with his progress. For myself, I can only be thankful that I do not have to overload my son's system with all manner of toxic chemicals that are routinely prescribed in the hospitals for managing this condition. I am also thankful for Ifeanyi's life and health which are stronger every day. I have become more appreciative of the powers of herbs, balanced nutrition, healthy living and a positive frame of mind that will not succumb to fear and misinformation."

This, according to Agbai is by no means a complete list of foods that aid in the treatment of sickle cell disease: African yam; alfalfa sprouts; apricot; bamboo shoot; banana; bitter almond; broccoli; Brussels sprouts; buckwheat; buffalo berry; cabbage; carrot; cassava; cauliflower; cherry; chickpea; cloudberry; elderberry; flaxseed; kohlrabi; lentils; lima bean; macadamia nuts; millet; mustard green; peaches; plantain; plums; radish sprouts; raspberry; red clover; rutabaga; salmonberry; sorghum; strawberry; and turnips.

Ifeanyi is now seven years old and is doing well. The mother has been continuing his nutritional and herbal treatments. She recently started the African Children's Holistic Health Foundation to provide support for others afflicted with sickle cell anaemia.

There is some evidence that people with sickle cell disease are more likely than others to be deficient in the mineral zinc. Zinc supplementation at nutritional doses has been suggested for children with sickle cell disease.

In a placebo-controlled study, 42 children (ages four to 10) with sickle cell disease were given either zinc supplements (10 mg of zinc daily) or placebo for a period of one year. Results showed that by the end of the study, the participants given zinc showed enhanced growth compared to those given placebo. Curiously, researchers did not find any solid connection between the severity of zinc deficiency and the extent of response to treatment.

Zinc is thought to have a stabilising effect on the cell membrane of red blood cells in people with sickle cell disease. For this reason, it has been tried as an aid for preventing sickle cell crisis. In a double-blind, placebo-controlled study of 145 people with sickle cell disease conducted in India, participants received either placebo or about 50 mg of zinc three times daily. During 18 months of treatment, the zinc-treated subjects had an average of 2.5 crises, compared to 5.3 for the placebo group. However, zinc did not seem to reduce the severity of a crisis, as measured by the number of days spent in the hospital for each crisis.

Sickle cell disease according to some studies can also cause skin ulcers (non-healing sores). In a 12-week, placebo-controlled trial, use of zinc at 88 mg three times per day for 12 weeks enhanced the rate of ulcer healing.

Commenting on the study, Chukwunenye says "the high dosages of zinc used in the last two studies can cause dangerous toxicity, and should be taken-if at all-only under the supervision of a doctor. The nutritional dose described in the first study, however, is safe."

Meanwhile, a one-year-long, double-blind, placebo-controlled crossover study of 82 people with sickle cell disease tested a combination herbal treatment made from plants indigenous to Nigeria. The results indicate that use of the herbal mixture reduced the incidence of sickle cell crisis.

A very small double-blind, placebo-controlled trial found intriguing evidence that fish oil may reduce the frequency of painful sickle cell episodes, possibly by reducing the tendency of the blood to clot.

Numerous other herbs and supplements have been suggested for people with sickle cell disease, including alpha-linolenic acid, beta-carotene, coenzyme Q, folate, garlic, green tea, lipoic acid, magnesium, OPCs (oligomeric proanthocyanidins), suma, vitamin B1, vitamin B6, vitamin B12, vitamin C, and vitamin E, but as yet the supporting evidence for these treatments remains far too preliminary to be relied upon at all.5-27

A cell study at the Philadelphia Biomedical Research Institute, King of Prussia, Penn., tested the effects of green tea extract and aged garlic extract on dehydration of sickle cells. Such dehydration of the sickle cells further exacerbates damage to the cells and may increase clotting. Epigallocatechin gallate, a major antioxidant component of green tea extract, almost completely inhibited sickle-cell dehydration. The garlic extract reduced dehydration by 30 percent.

People with sickle-cell anaemia have elevated blood levels of homocysteine, a risk factor for coronary artery disease. In one study, conducted at the University of Alabama, Birmingham, this abnormal elevation persisted even after supplementation with 1,000 mcg of folic acid daily.

In a separate study, Professor Tay S. Kennedy, of the Children's Hospital of Philadelphia, Pennsylvania, measured folic acid and vitamin B12 levels in 70 sickle-cell patients, ranging in age from infancy to 19 years old. More than half of them did not consume enough folic acid from food and, despite daily supplementation of 1,000 mcg folic acid daily, 15 percent had low blood levels of the vitamin. Although most of the subjects had normal blood levels of vitamin B12, both B12 and folic acid levels declined with the subjects' age. Such findings suggest that people with sickle-cell anaemia need considerable folic acid.

In a small clinical trial conducted at the Philadelphia Biomedical Research Institute, Professor S. Tsuyoshi Ohnishi, found that a combination of several high-potency supplements greatly reduced symptoms of sickle-cell anaemia. Over six months, Ohnishi asked 10 patients to take six grams of vitamin C, 1,200 IU of vitamin E, 1,000 mcg of folic acid and six grams of aged garlic extract daily. Meanwhile, the subjects' twins took only folic acid. People taking the multiple supplements had only one-third the number of painful sickle-cell episodes, compared with the other group.

"An interesting observation was that most of the patients in the supplement group felt much more energetic after they had started the regimen," Ohnishi wrote in the journal Nutrition.

In a related laboratory study, Ohnishi found that S-allyl cysteine (found in aged garlic extracts), arginine, Pycnogenol, green tea extract, black tea extract, and vitamin E improved membrane integrity in sickle cells. Ginseng, ginkgo, and coenzyme Q10 also helped, but not to the same degree.

Scientists unanimously agree that sickle-cell anaemia and sickle-cell trait is genetic disorders and cannot be "cured" in the conventional sense. However, these recent studies clearly demonstrate that antioxidants and other supplements can compensate for some of the inborn defects of sickle-cell anaemia. For people with this disease, it means healthier red blood cells, less anaemia and pain, and other improvements in health.